Pneumococcal conjugate vaccination in children with recurrent acute otitis media: A therapeutic alternative?

Kempen, Muriel J.P. van; Vermeiren, Judith S.J.; Vaneechoutte, Mario; Claeys, Geert; Veenhoven, Reinier H.; Rijkers, Ger T.; Sanders, Elisabeth A. M.; Dhooge, Ingeborg

doi:10.1016/j.ijporl.2005.06.022

Cited by 48 publications

(24 citation statements)

References 37 publications

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“…As shown previously, once recurrent OM is established, PCVs may not reduce or may even increase OM episodes, largely of non-PCV13 serotypes [24,25]. A recent article from Finland supports these findings.…”

Section: Discussionsupporting

confidence: 61%

Impact of Widespread Introduction of Pneumococcal Conjugate Vaccines on Pneumococcal and Nonpneumococcal Otitis Media

et al. 2016

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Background. Pneumococcal conjugated vaccines (PCVs) impact on complex otitis media (OM; including recurrent, nonresponsive, and chronic OM with effusion) was greater than that on simple, acute OM in previous studies. Since complex OM is often a polymicrobial disease, we speculated that reduction of complex OM by PCVs would be associated with reduction of nonpneumococcal OM.Methods. In a prospective, population-based, active surveillance, all OM episodes submitted for middle ear fluid culture in children <3 years from 2004 through 2015 were included. Three sub-periods were established: pre-PCV, PCV7, and PCV13. Incidence rate ratios (IRRs) comparing the 3 periods were calculated for pneumococcal, nontypable Haemophilus influenzae (NTHi), Moraxella catarrhalis, Streptococcus pyogenes, and culture-negative OM.Results. Overall, 7475 episodes were included. Of all-NTHi cases in the pre-PCV period, 34% were mixed with Streptococcus pneumoniae. IRRs (95% confidence interval) comparing the pre-PCV to the PCV13 period were 0.02 (0.01-0.04), 0.12 (0.08-0.20), and 0.18 (0.15-0.21) for PCV7+6A serotypes, 5 additional PCV13 serotypes, and all-pneumococcal OM, respectively; non-PCV13 serotype episodes were not significantly reduced. IRRs for single NTHi, mixed NTHi + S. pneumoniae, and all-NTHi OM were 0.30 (0.25-0.35), 0.18 (0.13-0.24), and 0.25 (0.22-0.29), respectively. Moraxella catarrhalis, S. pyogenes, and culture-negative episodes were also significantly reduced.Conclusions. Both pneumococcal and non-pneumococcal OM episodes, enriched with complex cases, declined substantially in children <3 years following sequential PCV7/PCV13 introduction. The reduction in non-pneumococcal episodes may be attributed to early OM episodes prevention, resulting in a lower rate of complex, often non-pneumococcal OM.

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Section: Discussionsupporting

confidence: 61%

Impact of Widespread Introduction of Pneumococcal Conjugate Vaccines on Pneumococcal and Nonpneumococcal Otitis Media

et al. 2016

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“…Pneumococcal vaccination would be a promising modality for prevention of pneumococcal infection. However, the effectiveness of vaccination for the prevention of recurrent OM is contentious [28-30]. …”

Section: Discussionmentioning

confidence: 99%

In VitroStreptococcus pneumoniaeBiofilm Formation andIn VivoMiddle Ear Mucosal Biofilm in a Rat Model of Acute Otitis Induced byS. pneumoniae

Yadav

Chae

Song

2012

Clin Exp Otorhinolaryngol

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ObjectivesStreptococcus pneumoniae is one of the most common pathogens of otitis media (OM) that exists in biofilm, which enhances the resistance of bacteria against antibiotic killing and diagnosis, compared to the free-floating (planktonic) form. This study evaluated biofilm formation by S. pneumoniae on an abiotic surface and in the middle ear cavity in a rat model of OM.MethodsIn vitro biofilm formation was evaluated by inoculation of a 1:100 diluted S. pneumoniae cell suspension in a 96-well microplate. Adherent cells were quantified spectrophotometrically following staining with crystal violet by measurement of optical density at 570 nm. The ultrastructure of pneumococcal biofilm was assessed by scanning electron microscopy (SEM). For in vitro biofilm study, S. pneumoniae cell suspensions containing 1×107 colony forming units were injected through transtympanic membrane into the middle ear cavity of Sprague Dawley rats. The ultrastructure of middle ear mucus was observed by SEM 1 and 2 weeks post-inoculation.ResultsThe in vitro study revealed robust biofilm formation by S. pneumoniae after 12-18 hours of incubation in high glucose medium, independent of exogenously supplied competence stimulating peptide and medium replacement. Adherent cells formed three-dimensional structures approximately 20-30 µm thick. The in vivo study revealed that ciliated epithelium was relatively resistant to biofilm formation and that biofilm formation occurred mainly on non-ciliated epithelium of the middle ear cavity. One week after inoculation, biofilm formation was high in 50% of the treated rats and low in 25% of the rats. After 2 weeks, biofilm formation was high and low in 25% and 37.5% of rats, respectively.ConclusionThe results imply that glucose level is important for the S. pneumoniae biofilm formation and S. pneumoniae biofilm formation may play important role in the pathophysiology of OM.

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“…They explain this decreasing of otitis by the success of information on rhinopharyngitis disinfections towards the parents and the possible efficiency of the pneumococcus' vaccine (Prevenar 1 ). The vaccine is not efficient to prevent AOM for the children aged more than 1 year and suffering from repetitive AOM [14][15][16]. Finally, an antibiotherapy given 48 h before the oto-rhino's medical advice can change the appearance of the eardrum, mislead the ENTS who will diagnose a serous otitis and take part in an over diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Clinical qualitative evaluation of the diagnosis of acute otitis media in general practice

Legros

Hitoto

Garnier³

et al. 2008

International Journal of Pediatric Otorhinolaryngology

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Pneumococcal conjugate vaccination in children with recurrent acute otitis media: A therapeutic alternative?

Cited by 48 publications

References 37 publications

Impact of Widespread Introduction of Pneumococcal Conjugate Vaccines on Pneumococcal and Nonpneumococcal Otitis Media

Impact of Widespread Introduction of Pneumococcal Conjugate Vaccines on Pneumococcal and Nonpneumococcal Otitis Media

In VitroStreptococcus pneumoniaeBiofilm Formation andIn VivoMiddle Ear Mucosal Biofilm in a Rat Model of Acute Otitis Induced byS. pneumoniae

Clinical qualitative evaluation of the diagnosis of acute otitis media in general practice

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